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Ulcerative Colitis

Ulcerative Colitis is a chronic autoimmune inflammatory bowel disease which affects the colonic mucosa. The main symptom is bloody diarrhea and abdominal pain, which flares up and retreats back into remission seemingly unpredictably.

Inflammatory Bowel Disease includes two main conditions. Crohn’s Disease and Ulcerative Colitis.

Ulcerative Colitis is a chronic autoimmune inflammatory bowel disease which affects the colonic mucosa in the rectum through to other parts of the colon, sometimes all the colon[1]. The main symptom of ulcerative colitis is bloody diarrhea and abdominal pain, which flares up and retreats back into remission seemingly unpredictably.

Risk factors include genetics and bacterial infections such as Salmonella and Campylobacter. Symptoms can start at any age from childhood to adulthood, but typically begin in early adulthood[2]. Ulcerative colitis is typically treated with aminosalicylates, corticosteroids and immunosuppressants.

It is becoming increasingly clear that the gut microbiome has a significant impact on inflammation in the digestive system and therefore should play a key role in managing ulcerative colitis. As bacteria can be transient in the digestive tract, it is likely that a long-term plan of probiotics and additional support of prebiotics, anti-bacterial herbs and anti-inflammatory agents will be needed to support the environment of the digestive tract[3].

Diet

Firstly, identifying if you have an allergy or intolerance to gluten or dairy will be significant in your protocol.

Having an anti-inflammatory diet full of healthy fats such as extra virgin olive oil, oily fish (salmon, mackerel and sardines), avocados and nuts and seeds will help to reduce inflammation in the digestive tract. Healthy fats also support the nervous system and can reduce feelings of stress. Stress has been indicated as a trigger for Ulcerative Colitis.

Additionally, including anti-inflammatory support from nourishing foods in your diet such as turmeric and ginger and reducing inflammatory and gut stimulating foods and drinks such as sugar, alcohol and caffeine will beneficial.

Digestive support through foods such as fibre, probiotics and prebiotics will help to build a healthy terrain in the digestive tract. Examples of probiotic foods include kefir, sauerkraut, kimchi and yogurt. Prebiotic foods are what feed our good gut bacteria, examples are Jerusalem artichoke, garlic, onions, leeks and fibre from foods such as legumes and pulses. Be aware that introducing these digestive foods too quickly in your diet can cause digestive issues, so start slowly and with small portions and build you way up.

Supplements

A high strength probiotic first thing in the morning or last thing at night will help to populate your microbiome with beneficial bacteria. Saccharomyces Boulardii is specific strain that is generally given to patients with diarrhea associated gut issues and is also helpful in modulating the immune system.

Curcumin is a potent anti-inflammatory herb which has been shown to put some patients into remission from ulcerative colitis[4]. Curcumin is the active element in turmeric. You can add turmeric to foods regularly, but for therapeutic support a supplement will be more effective.

Aloe vera juice has strong anti-inflammatory effects on the digestive system, it can also soothe gastric and skin ulcers. Adding in some aloe vera daily could help with reducing symptoms of ulcerative colitis.

A fish oil with good levels of EPA and DHA will be supportive for reducing inflammation.

Nutrients which help to strengthen the gut integrity and also modulate the immune system are zinc, vitamin A and vitamin D.

B vitamins are often deficient in people with ulcerative colitis due to absorption issues and this can further hinder digestive processes. Taking a vitamin B complex will help to restore levels in the blood.

Steroid medications are commonly given to people with autoimmune conditions. Steroids can impact our calcium levels so if you are taking a long course of steroids to manage your symptoms it might be worth supplementing with a good calcium supplement to help with bones.

Finally, iron is another mineral which can be deficient in people with digestive issues as their ability to absorb nutrients is decreased. Have your iron levels tested before supplementing.

Possible testing options

Comprehensive stool analysis: there are various testing companies that do stool tests to analysis the gut microbiome, inflammatory markers, biomarkers for leaky gut (intestinal permeability) and digestive enzymes, all which can play a part in the pathogenesis of Crohn’s Disease. Here is a link to information about one of our tests.

Calprotectin: this is a useful marker that is usually monitored by the NHS for people with Crohn's and this is a marker on our complete digestive analysis testing too. Calprotectin is a protein found in white blood cells and is a biomarker to test for inflammation in the digestive system. People with active Crohn’s Disease or Ulcerative Colitis usually have high calprotectin levels.

Nutritional Therapy

Our Nutritional Therapy team are experts in treating digestive health conditions. Click here for more information.



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Disclaimer

Please note that the information contained within this website does not and should not replace medical advice, and is not intended to treat or diagnose. We always recommend you consult with your doctor. Our Nutritional Therapy team is highly trained and we offer one to one Nutritional Therapy Consultations, which are designed to be complementary to any medical treatment from a functional medicine approach, as well as offering a preventative & optimal health focus.